MyRYTARY is a personalized program helping patients connect to case management, access support, affordability support, and educational resources.

Affordability Support
Case Management & Educational Resources
Access Support

We help your patients with access to RYTARY through:

  • Rapid benefits investigation
  • Assistance in understanding and navigating the prior authorization process
  • Assistance with the exception and appeals process
  • MyRYTARY Start Program
    This program may give patients access to RYTARY at no cost during the payer approval and the patient’s dosage conversion and adjustment processes.
    • Up to three (3) months
    • If delays in the Payer Approval process persist beyond three (3) months, additional free product may be available upon request. Please call 1.844.IMPAX2U for terms and conditions.

Enrolling a patient in the MyRYTARY Patient Support Program is easy!

Simply print out the appropriate form below. Complete all fields with black ink and fax it to us at 1.844.IMPAX08.

Patient Enrollment Form

New to RYTARY?

Requires patient and prescriber signatures.

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Patient Authorization Form

Already on RYTARY?

Requires patient signature only.

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MyRYTARY Start Program

MyRYTARY Start Program can provide access to RYTARY at no cost to any new patients while they are going through the Payer Approval and dose conversion and medication adjustment process. Eligible patients who have been prescribed RYTARY for an FDA-approved indication, have achieved a stable dose, and who are experiencing delays in obtaining a final insurance coverage determination / alternative funding search decision can receive additional vouchers for free goods upon request. The free product is offered to eligible patients without any purchase contingency or other obligation.

To Learn More
Phone support is available Monday-Friday
between 8AM and 8PM (EASTERN TIME ZONE).